Polypharmacy is a common problem in primary care. It is defined loosely as the use of 5-10 medications or more and is estimated to affect over 50% of Medicare beneficiaries and over 84% of elderly cancer patients. All of this medication is associated with increased risk of experiencing an adverse drug reaction and hospitalization.
Here on iMedicalApps we have reviewed several resources to assist providers in caring for patients with polypharmacy including many from the American Geriatrics Society: Geriatrics at Your Fingertips, Multimorbidity/MCC GEMS, and iGeriatrics. iGeriatrics includes the popular Beers Criteria to aid in deprescribing. Also popular are the STOPP criteria found here. None of these lists are based on particularly solid evidence but are great starting points to discussing deprescribing with patients and their families.
Most recently I reviewed a new website called MedStopper, which I really liked, but MedStopper isn’t a native medical app. MedStopper is a deprescribing tool in which providers enter various patient medications and it outputs recommendations on what medications to consider stopping, including how to taper them.
The newest medical app to assist with polypharmacy comes from the National Health Service (NHS) Scotland called Polypharmacy Guidance. The purpose of Polypharmacy Guidance is to assist providers in completing comprehensive medication reviews on patients at risk, or suffering from, polypharmacy. Polypharmacy Guidance utilizes a seven step process first released in 2012 to guide providers through a point of care comprehensive medication review.
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Evidence based medicine
Polypharmacy guidance is largely based on expert opinion regarding the derivation of the 7 step process. However, the Polypharmacy guidance contains an abundance of evidence based references for adverse drug reactions, numbers needed to treat/harm for numerous medications, frailty, and which patients should be targeted for a comprehensive medication review.
Who would benefit from this medical App?
Any healthcare provider who cares for geriatric patients or patients of any age on too many medications including pharmacists, students, NP’s, PA’s, geriatricians and other primary care providers.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Easy to follow (but time consuming) seven step medication review process.
- Easy to use at the point of care with patients and families.
- Numerous evidence based resources on medications including NNT/NNH, frailty.
- Links to handouts, tables, charts.
- 7 step process is time consuming.
- No ability to actually “input” medications for medical app to recommend deprescribing.
- No ADR calculator built into app (just a nice table and other written information).
The Polypharmacy guidance medical app is a great tool for providers caring for geriatric patients or any patient on “too many” medicines. The polypharmacy app is ideal for patient care teams involving a geriatrician and/or pharmacist who can sit down for an extended session with the patient and their family for a comprehensive medication review.
- Overall Score
- User Interface
Intuitive interface with built in 7 step process and evidence based resources clearly laid out.
- Multimedia Usage
The medical app contains abundant information including data on NNT/NNH, ADRs, and handouts for patients and families on “sick days” and dehydration, frailty, prognosis, etc.
App is free.
- Real World Applicability
This is a medical app I could start using tomorrow and hope that other providers will too and could be integrated into outpatient and inpatient interprofessional teams involving primary care, geriatrics, palliative care, nursing and pharmacy.
- Device Used For Review
iPhone 6S running iOS 9.2
- Available for DownloadAndroidiPhoneiPad